Massachusetts Homeless Triage Assessment
Publisher: Cambridge, MA: Mathematica Policy Research
This report presents findings from a rapid cycle evaluation of an operational component of a Pay for Success initiative administered by the Massachusetts Housing and Shelter Alliance (MHSA). The initiative is designed to place chronically homeless individuals into housing as quickly as possible in an effort to reduce the cost of emergency health services used while homeless. MHSA member providers perform a triage assessment to identify which homeless individuals will be most likely to use emergency health services such as emergency rooms, hospitals, shelters, detox centers, and ambulances. Individuals predicted to be high utilizers are assigned higher scores and are prioritized for housing placement. The analysis used a combination of administrative triage scoring data and self-reported data on subsequent service use to determine whether the triage and assessment tool effectively identifies chronically homeless participants who will frequently use health services in the future. The study found that the triage assessment score effectively identifies subsequent service use.
- The study provided evidence that the triage scoring metric is a strong predictor of subsequent service use. Of the 10 outcomes examined, the associations with the triage total score were in the expected directions for all outcomes and were statistically significant for the majority (6 of 10) of outcomes. Having a higher triage total score was associated with receiving outpatient mental health treatment, receiving outpatient substance abuse treatment, visiting an emergency room, being hospitalized, using an ambulance, and spending time in a detox center.
- Compared with the total score, triage component scores were less predictive of service use across the full range of outcomes but were strong predictors for specific outcomes.